How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $53.70 | Professional | None | $30.20 | $30.20 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $67.61 Typical High $81.28 | Facility | None | $52.48 | $67.61 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $74.13 Typical High $87.10 | Professional | None | $38.02 | $74.13 | $87.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $7.41 Typical High $8.71 | Professional | RR · Rental | $5.62 | $7.41 | $8.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $54.95 Typical High $64.57 | Professional | UE · Used equipment | $41.69 | $54.95 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
ConnectiCare Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $131.83 | Professional | None | $100.00 | $100.00 | $131.83 |
United Setting Professional Modifier None Typical Low $10.96 Median $33.11 Typical High $38.90 | Professional | None | $10.96 | $33.11 | $38.90 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $15.14 Typical High $26.92 | Professional | 52 · Reduced service | $15.14 | $15.14 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $10.72 | Professional | 53 · Discontinued | $6.03 | $6.03 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $7.94 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $5.37 |
Where Connecticut sits
The same service costs 2.7 times more in Hawaii than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 24th of 51
$53.70
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.